Op/Ed: Federal Price Controls on Health Care Would Harm Montana

Price controls are a primary hallmark of a socialist economy. When the government takes over in any market, bad things happen. Whether it is bread lines in the former USSR or the dire lack of medicines in today's Venezuela, price controls lead quickly to shortages, rationing, and worse.

These are not consequences we want for our health care. Can you imagine telling a breast cancer patient there are no oncology appointments available until next year? Or what about a young person suffering a first schizophrenic episode if there's no psychiatrist within 500 miles to assist?

Sadly, Montanans could be facing more of these problems soon, because price controls are creeping up on federal lawmakers like a wolf in sheep's clothing. Congress is now considering legislation that would mandate "federal benchmark pricing" on most health care provided outside of a health insurance network. 

These leaders say they want to protect families from surprise medical bills, and that's a fine idea. Patients who do everything possible to obey their health plans' rules should not find out weeks after surgery that they owe thousands of dollars because, unbeknownst to them, the anesthesiologist on their case wasn't in-network. As the insurance options have narrowed, patients are increasingly forced into out-of-network providers to meet their health care needs. A letter from February of this year to the House Ways and Means committee expressed serious concerns about "benchmark pricing" and was signed by the American Medical Association and over 120 of their peer organizations. 

But no matter what problem price controls are intended to solve, they only make things worse. In the case of this legislation, government-mandated pricing would drive doctors away from rural areas, cause hospitals to close, and devastate Montanans' precarious access to health care.

That's a price we cannot afford. Already, 52 of our 56 counties don't have enough primary care services for patients, and nine don't have any doctors at all. We're also short on nurses and in many areas, specialty care is non-existent.  This means pregnant mothers are traveling great distances for every prenatal checkup, heart disease patients must head to the nearest big city to find a cardiologist, and mental health care can be almost impossible to schedule.

As a state legislator, when I look at any health care proposal, I ask myself whether it will improve or reduce patients' access to care. It's why I support programs paving the way for our rural students to go to medical school, so they can come back home to practice. It's also why I oppose any policies that put paperwork ahead of patients, adding more bureaucracy to an overburdened system. And it's why I am speaking out now against price controls. 

This doesn't mean I'm giving up on protecting patients from unexpected medical bills. There are simply better answers out there.

Other plans would treat surprise billing for what it really is-a payment dispute between doctors and insurance companies. There's no reason to have patients in the middle, on the hook for a huge sum, just because those parties disagree. The prices at a store are not variable based on disputes between suppliers and the retailer and neither should the prices that we are paying at the hospital. Alternative surprise billing solutions would use mediation between insurers and providers to arrive at a reasonable payment, and insurance plans, not families, would pick up the tab.  

Patients deserve protection from surprise medical bills-but they also deserve access to health care when they need it. If price controls are the best solution Congress can come up with, maybe they should leave this issue to the states. The Montana Legislature is looking at various solutions, and I believe we can bring the right people together and find the right way forward for our citizens, leaving the crazy socialist ideas in Washington.

Rep. Dennis Lenz is the chairman of the Montana House Human Service Committee.